He commented on another article in the journal on the marketing of genetic screening tests. It is generally agreed that while genetic testing can be very valuable for individuals or families known to be at high risk for an inherited disease, genetic screening tests aimed solely at showing a patient's statistical risk of developing multi-gene diseases such as diabetes or heart disease are seldom clinically useful and often quite misleading. Despite this a firm called Navigenics will very happily sell you one of this fishing-expeditiona genetic screening tests for a modest $999. What the research focused on was the fact that a national primary-care practice group, MDVIP, entered into a marketing agreement with Navigenics to promote this test to their patients, and that as part of this relationship, the company offered a free genetic screening test to these primary physicians, 1/3 of whom accepted the offer.

I'll pick up the commentarty from here in Dr. Wilkes's own words:

An offer of an incentive (in this case a free genetic test) from a new “collaborator” should clearly have raised questions for every one of the doctors. Even if any given doctor genuinely believed the test was in the best interest of a patient, it would be difficult to argue that the test ordering wasn’t influenced by a favor provided by Navigenics with an implicit expectation of reciprocity (“we did you a favor, now it is expected you will do us a favor by ordering this test on your patients”)....Is this type of social influence any different than offer of free drugs to doctors by pharmaceutical companies in an attempt to build loyalty?...

I wonder if any MDVIP physicians ever told their patients that they received a free gift by the very company that profited from the test the doctor was about to order—a test that has no proven value to the patient? Similarly, prior to testing, did the physicians include in their conversations with patients a discussion around informed consent? ...

It seems we have been round this issue before with pharmaceuticals and medical devices. As a profession, haven’t we decided that education developed by a company with a vested interest in the physician’s practice outcomes is not ethically or educationally appropriate? ...

Primary care doctors can either be part of the problem or we can be part of the solution by being vigilant and by self policing to avoid any actual or perceived conflicts of interest in order to maintain the trust of our patients and society. We also need to be informed consumers when it comes to our own education and avoid all commercial influence that seeks to promote profit at the expense of patient well being.